Frequently Asked Questions About Acoustic Neuromas
What Causes Acoustic Neuromas?
The cause of acoustic neuromas is unknown. It is thought that this tumor occurs when there is a defect in a certain type of tumor suppressor gene. These tumors may sometimes occur in a hereditary disease called neurofibromatosis type 2 (also known as von Recklinghausen disease).
How Often Are Acoustic Neuromas Seen?
Acoustic neuromas are generally seen in 10 people per million. They are most commonly seen between the ages of 30-60 and are more common in women.
How Are Acoustic Neuromas Diagnosed?
Contrast-enhanced brain MRI is the best method used in the diagnosis of acoustic neuromas.
How Are Acoustic Neuromas Treated?
The larger the tumor, the more complex and difficult the treatment will be, so early diagnosis and early treatment are very important. In the treatment of this tumor, a neurosurgeon and an ear, nose, and throat surgeon usually work together. The most effective surgical approach is chosen according to whether there is hearing loss and according to the size and position of the tumor. The aim of surgical intervention is to preserve and restore the patient’s balance, facial expressions, facial sensation, and vision. Since the tumor develops around the 8th nerve responsible for hearing, hearing loss is usually permanent. Hearing lost before surgical intervention does not return. If the tumor is large, hearing loss is usually complete. During the removal of large tumors, the nerve that controls the facial muscles is often damaged, so permanent facial paralysis may occur. Very large tumors may press on the brainstem and block the normal flow of cerebrospinal fluid. In this case, fluid accumulation in the brain, namely Hydrocephalus, may occur. This is a life-threatening condition. In this case, the aim of surgery is to provide the normal flow of the fluid accumulated in the brain and to relieve the pressure on the brainstem. Common side effects after surgical intervention are headache, nausea, restlessness, and difficulty with coordination. These side effects usually decrease within a few weeks. In some cases, rehabilitation treatment may be required. The purpose of stereotactic radiosurgery is to slow or stop tumor growth; it is not to cure or destroy the tumor. Radiosurgery is generally applied to elderly patients and to patients whose general health condition cannot tolerate surgery. In some cases, radiosurgery may also be used to destroy tumor pieces that may remain after surgery. Radiosurgery can only be applied to small tumors. Radiosurgery may also sometimes cause facial paralysis or hearing loss. Observation. Since these tumors generally grow very slowly, they may often remain without causing any symptoms. In this case, they can be followed at regular intervals with MRI to monitor whether they are growing.
What Are the Post-Treatment Expectations for Acoustic Neuromas?
Acoustic neuromas are benign, non-cancerous tumors. They do not spread (metastasize) to other parts of the body, but they may continue to grow and press on important structures within the skull. With surgical intervention, the tumor can be completely removed in 95% of patients. The risk of death from this surgery is less than 1%. Permanent facial paralysis does not occur in approximately 95% of patients with small tumors. However, permanent facial paralysis is seen after surgery in approximately two-thirds of patients with large tumors. In approximately half of the patients with small tumors, some hearing will remain on the side where the tumor is located. Undesirable conditions such as nerve damage, hearing loss, and facial paralysis may appear even after a certain period following radiosurgery.
In Which Age Ranges Is Acoustic Neuroma More Common?
Acoustic neuroma generally occurs between the ages of 30-60 and is slightly more common in women than in men.
What Symptoms Does Acoustic Neuroma Show?
Acoustic neuroma usually causes hearing loss, tinnitus, and balance problems. Other symptoms such as headache, facial paralysis, and seizures may also be seen.
How Is Acoustic Neuroma Surgery Performed?
Acoustic neuroma surgery may vary depending on the size and location of the tumor. Generally, an incision is made behind the ear and a special procedure performed under the microscope by neurosurgeons is used to remove the tumor. However, complete removal of the tumor may not be possible because it can cause hearing loss.
